Claim For Employee Travel Expense Form
Download a blank fillable Claim For Employee Travel Expense Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Claim For Employee Travel Expense Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Reset Form
Financial Services Use Only
CLAIM FOR EMPLOYEE TRAVEL EXPENSE
Clear Expenses From Travel Request
Use This Form To
Prepared by: ____________________ Ext.: _______
Date: _______________________________________________
I declare under penalties of perjury that this claim (including any
accompanying evidence) has been examined by me and to the best
of my knowledge and belief is a true and correct claim in best
Employee ID No.: _____________________________________
conformance with the governing statutes and the rules and
regulations as promulgated by the Board of Examiners.
Name: ______________________________________________
I do
I do not have a travel advance
Title: _______________________________________________
Claimant Signature Required
Date
Sort Code / Extension: _________________________________
TRAVEL EXPENSE WORKSHEET
Travel Date
Day of Week
Departure Time
Arrival Time
Return Time
Amount
Amount
Amount
Amount
Amount
Amount
Amount
Total
Airfare
Hotel
$ 0.00
Room Tax / Fees
$ 0.00
$ 0.00
Auto Rental
$ 0.00
Taxi / Bus / Shuttle
$ 0.00
Mileage
$ 0.00
Fuel / Tolls
Hotel Parking
$ 0.00
Airport Parking
$ 0.00
$ 0.00
Calls / Internet
$ 0.00
Meals / Incidentals
$ 0.00
Miscellaneous
$ 0.00
Meals Not Claimed
Total
$ 0.00
Breakfast
Lunch
Dinner
I/E
Total
Federal Per Diem Rate
Maximum Lodging
$ 0.00
Federal Lodging Rate
Total
$ 0.00
NOTE: With the exception of per diem and incidental expenses, all claimed expenses must be documented. In-state
travel requires the approval of the dean/director. Out-of-state travel also requires the approval of the vice president.
Approved by Dean/Director
Date
Approved by Vice President
Date
ACCOUNTING INFORMATION
CLAIM SUMMARY
Total of this Claim
(complete ll fields)
FUND
AREA
ORGN
OBJ
SOBJ
AMOUNT
Air Fare to Travel Agency
$ 0.00
Prepaid Expenses (Team/Group)
T1
22
Balance of Claim
22
T2
$ 0.00
Advance Received
22
T8
(Total must match worksheet total)
Balance Due Traveler (College)
TOTAL
$ 0.00
$ 0.00
DISTRIBUTION: ONE COPY - FINANCIAL SERVICES J1C
ONE COPY - DEPARTMENT
Revised 6/11
Revised 4/13
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial